Healthcare Provider Details

I. General information

NPI: 1194793190
Provider Name (Legal Business Name): WINIFRED MASTERSON BURKE REHABILITATION HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 11/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

785 MAMARONECK AVE
WHITE PLAINS NY
10605-2523
US

IV. Provider business mailing address

785 MAMARONECK AVE
WHITE PLAINS NY
10605-2523
US

V. Phone/Fax

Practice location:
  • Phone: 914-597-2500
  • Fax: 914-597-2760
Mailing address:
  • Phone: 914-597-2232
  • Fax: 914-597-2787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number1046
License Number StateNY

VIII. Authorized Official

Name: SCOTT A EDELMAN
Title or Position: SENIOR VP/CFO
Credential:
Phone: 914-597-2277